Corporate Compliance

Note from the instructor: July 2012 quarterly update contains multiple significant updates and clarifications

Medicare Insider, June 12, 2012

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Editor's Note: Kimberly Hoy, Esq., director of Medicare and compliance for HCPro, Inc., is the author of this week's note from the instructor.

There were a number of interesting items in the July 2012 update to the hospital Outpatient Prospective Payment System. The Claims Processing Manual transmittal had several new and replacement codes that hospitals should take note of and make appropriate chargemaster changes. The quarterly update also included a Benefit Policy Manual transmittal with three clarifications, including a new section on packaged self-administered drugs.

There were seven new category III CPT codes adopted for July 2012, including new codes related to intracardiac ischemia monitoring systems (0302T-0307T) and a replacement code for insertion of ocular telescopic prosthesis (0308T), which should be used to replace deleted code C9732 effective July 1, 2012.  Also effective July 1, 2012, the pass-through code C1840 formerly billed with deleted code C9732 must be billed with new code 0308T to receive pass through payment.

There were also two new biologicals approved for pass through payment effective July 1: C9368 (Grafix Core, per square centimeter) and C9369 (Grafix Prime, per square centimeter).  CMS also adopt six new drug codes, three of which are replacement codes for existing drug codes that will no longer be billable effective July 1, 2012.

Continue reading Kimberly's note at the Medicare Mentor Blog.

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